Chronic Fatigue Syndrome

Lisa Kirk’s article “Chronic Fatigue Syndrome” provides relevant information supported by strong evidence about the disease and its impact on patient’s emotional state. The article certainly catches attention, because it provides thorough examination, causes and treatment methods of the mentioned syndrome and can be used not only by students, but also by professionals in health care. It means that the provided information is of great importance for disease treatment and prevention. (Kirk 2005)

The article argues about the origins of the chronic fatigue syndrome or CFS trying to determine whether CFS is psychological, hypothalamic or immunological disorder. However, CFS can be also the combination of three areas mentioned above. Nevertheless, Lisa Kirk, the author of the article, suggests that all treatment methods are successful and patients may afford them in order to be provided with opportunity to manage the copious disease. The author points out that CFS is chronic disease as it requires more than six months of persisting.

Kirk asserts that CFS can’t be associated with symptomology as well as with other medical conditions. It means that the patient has to provide strong evidence and personal reports to be diagnosed with CFS. (Kirk 2005) The author provides the main symptoms associated with the disease suggesting that CFS is characterized by debilitating fatigue, tender lymph nodes, tenderness and pain in muscles, joint pain, postexertional malaise, feverish feelings and finally long-lasting chills. It is noted that CFS may cause psychological effects such as depression and mood lability.

Kirk quotes famous researchers who argue that CFS may be genetic etiology or predisposition. Concerning symptoms exposure it is admitted that the syndrome is frequently found in monozygotic twins rather than in dizogotic twins. Actually CFS disturbs significantly the hypothalamic-pituitary-adrenal axis. What is more important is the author provides significant correlation between onset of disease and stress intensity. (Kirk 2005) The article figures out the primary causation of the CFS disorder considering them to be psychiatric reaction to a certain traumatic physiological event.

It is hypothesized that many patients undergo physiological symptoms in a negative and catastrophic manner meaning that patients may suffer, for example, from cognitive misinterpretation of a bodily function which significantly limits their physical activities. It can result in perpetuated poor health and under-utilization of muscles. (Kirk 2005) The article also deals with the main treatment methods of disease managing. Many researches conducted assert that cognitive treatment one of the best methods used in medicine.

According to the article the cognitive treatment is able to provide a patient suffering from CFS with proper information how develop appropriate, healthy responses to bodily functions and how to interpret them accurately. This treatment approach is thoroughly examined by the author stating that it consists of the following steps: education, acquisition of skills, rehearsal of reframed cognitive reactions/responses and generalization along with maintenance. Kirk mentions the five assumptions which inspire the cognitive therapy considering that it address not only the emotional and cognitive facets, but also behavioral ones.

Kirk 2005) One more treatment approach is considered to be a multi-disciplinary treatment which is the most important for treating the modality for a patient having CFS. It is recommended to include individualized treatment plans with the intention to provide patient with appropriate medical and psychological help, psychiatric and physical involvement as well as with medical/personal reports. Nevertheless, Kirk assumes that treatment of a CFS patient has to combine appropriate sleep hygiene, exercise, diet, adjunct medications, cognitive/behavioral therapy and antidepressants usage.

Brown’s article “Psychological Mechanisms of Medically Unexplained Symptoms an Integrative Conceptual Model” deals with recent developments in health care area. The article catches attention as it provides useful tool to organize available research and theory and can be used by scientists and students who wants to generate new hypotheses concerning these phenomena. (Brown 2004) The article provides a critical overview of different theories aimed at explaining the pathogenesis of medically unexplained symptoms.

Furthermore, Brown considers both the merits and the limitations of current ideas and recent developments in the related area. The author argues that different theories are able to succeed in explanation of unexplained illness. Nevertheless, the author asserts that the theories are limited and they can’t accommodate available evidence concerning these conditions, because all the theories fail to provide “a satisfactory account of how apparently compelling symptoms can exist in the absence of significant organic pathology”. Brown 2004) The article suggests a new model aiming at addressing the contemporary cognitive psychological research. The model has been developed to integrate current concepts and to provide explanatory framework. The model isn’t indented to supercede the already existing theories and concepts. (Brown 2004) The author summarizes theories of medically unexplained illness and claims that all of them are based on the somatization, dissociation and conversion. Brown provides relevant evidence to support his theory and to describe the merits and disadvantages of each approach.

The author argues in the article that all the theories are created with the only purpose to provide understanding of unexplained illness, however, the theories have failed to clarify the phenomenon. (Brown 2004) According to Brown, the suggested model is based on cognitive psychological principles. The model is intended to combine existing theoretical approaches and to extend previous theories providing explanation of compelling symptoms existing in the absence of organic pathology. What is more important is that Browns considers the empirical and clinical implications of the model.

The author mentions that medical practitioners pointed out the symptoms of physical illness which can’t be explained. Such events often occur in medicine and thus proper explanations must be found in order to define the proper treatment methods. Brown admits that about 30% of the detected symptoms defy adequate physical explanation. (Brown 2004) The symptoms may represent “the somatic component of a diagnosable psychiatric condition” involving depression and anxiety, though they are not recognized by physician.

Actually normal bodily sensations are considered evidence of serious underlying pathology. (Brown 2004) It is noted in the article that no relevant explanation for such symptoms is either provided or pointed out. Brown says that many medically unexplained diseases may inevitably result in stresses, depressions and anxieties if they remain unresolved. They can even lead to disability that may persist with time. The patients are faced with suffering and uncertainty, repeated consultations and investigations. It means that burden to the health care services is really significant.

The reason is that for patients suffering from unexplained symptoms health care costs may be up to nine times higher. (Brown 2004) Therefore the article is a serious attempt to explain theoretical models of medically unexplained symptoms. Multiple researches are cited to support the evidence. It is apparent that Brown’s research is highly motivated by conversion and dissociation and tries to provide understanding of the unresolved symptoms. Model offered by Brown provides a useful frame how to organize the existing theories and to assist developing of effective strategies aimed at problem solution. Brown 2004) Steve Cole’s article “Elevated Physical Health Risk among Gay Men Who Conceal Their Homosexual Identity” examines the infectious and neoplastic diseases among gay men participated in the Natural History of AIDS Psychosocial Study. Steve Coles admits that men concealed their homosexual identity suffer from higher incidence of cancer, pneumonia, bronchitis, sinusitis, and tuberculosis. It is apparent that the purpose of the article is to provide the correlation between concealed emotional expression and infectious diseases. (Cole 2004)

The thesis of the article is if people conceal their emotional state, it will lead to serious psychological disorders as well as to infectious diseases mentioned above. The effects of concealed emotions don’t depend on differences in age, ethnicity, health-relevant behavioral patterns, repressive coping style and socioeconomic status. Results obtained from different researches indicate that concealed homosexual identity is interrelated with health outcomes. (Cole 2004) Cole and other researchers strongly claim that psychological inhibition is linked to physical illness.

Furthermore, inhibited psychosocial characteristics are associated with increased risk of cancer disease. The empirical researches consider concealed expression of emotions to be a major factor that may cause several types of disease such as cancer, hypertension, and rheumatoid arthritis. (Cole 2004) Concerning the mechanism it is noted that the incidence of infectious disease have been “assessed over 5 years in 222 HIV-seronegative gay and bisexual men”. (Cole 2004) Participant received a medical examination every six months.

Furthermore, they were provided with blood drawn and were often asked about their physical and psychological health as well as bout their behavioral characteristics. It the result it was found out that emotional state is able to cause physical and infectious illness as well psychological disorders including anxiety, depression, negative affectivity, etc. Leupold’s article “Emotions in a Plethysmograpgh” examines the role of emotional state in eliciting asthmatic exacerbations. Actually the article provides psychosomatic theory supported by the evidence and experiments conducted by psychiatrists.

The role of strong emotions was studied in asthmatic patients, though healthy individuals were paid less attention. Leupold argues that measuring procedures “have partially been held responsible for conflicting results”. The article examines thoroughly the experiment conducted on twenty healthy volunteers. The purpose of the test was to examine the influence of emotions on airway obstructions. (Leupold 2004) The results indicated that watching affective films can cause different emotions including amusement, sadness and a neutral feeling.

What is more effective it was pointed out that emotional state was able to cause asthmatic airway obstructions in patients. The volunteers were presented short movie clips illustrating sadness, amusements and other affective states. The volunteers were seating in the “glass box of a whole body plethysmograph”. After each video presentation, thoracic gas volume and specific airway resistance were measured. (Leupold 2004) Leupold says that relevant affective states were induced to provoke the patients to express their emotions and to examine emotional impact on health.

It is admitted that airway obstructions were detected in patients while watching both the negative and positive movie clips in the neutral conditions. The effect on mood induction wasn’t obtained, however. Although the experiment proved that emotional state of the patients was affected by films clips, the research was limited, because the auditory wasn’t of great quality as there was no glass door between the viewers and the screen. The second reason is that breathing through the mouth piece disturbed the full concentration on the movie clip. The effect was claimed to be independent of the emotional states induced. (Leupold 2004)